Citation

Wan FJ, Chien WC, Chung CH, Yang YJ, Tzeng NS. J. Affect. Disord. 2020; 265: 381-388.

Affiliation

Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC; Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, ROC. Electronic address: pierrens@mail.ndmctsgh.edu.tw.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.jad.2020.01.063

PMID

32090763

Abstract

BACKGROUND: This study aimed to investigate the association between traumatic spinal cord injury (TSCI) and the risk of affective and other psychiatric disorders, and the role of the rehabilitation therapies.

METHODS: In this population-based, retrospective cohort study, we used Taiwan's National Health Insurance Research Database to analyze the patients who were newly diagnosed with TSCI between 2000 and 2015 were included, with a 1:3 ratio by age, sex, and index year matched in the non-TSCI comparison group, for the risk of affective and other psychiatric disorders.

RESULTS: In total, 5375 out of 16,151 patients with TSCI developed psychiatric disorders, and 1467 out of 48,543 patients in the non-TSCI group developed psychiatric disorders (2930.88 vs 2823.29 per 100,000 persons/year). The Kaplan-Meier analysis showed that the TSCI cohort had a significantly higher risk of psychiatric disorders (log-rank, p < 0.001). Fine and Gray's survival analysis revealed that the adjusted hazard ratio was 1.977 (95% CI: 1.914-2.042, p < 0.001). Rehabilitation therapies, including physical and occupational therapies, within 90 days after the injury, was associated with a lowered risk of psychiatric disorders, including anxiety, depression, and bipolar disorder, in the TSCI cohort (adjusted HR = 0.702 [95% CI: 0.661-0.746, p < 0.001]). In the subgroups with low, medium, and high intensity, rehabilitation therapies were associated with a lowered risk of psychiatric disorders.

CONCLUSIONS: TSCI was associated with the risk of affective and other psychiatric disorders, and rehabilitation therapies were associated with a lowered risk of these in the TSCI cohort.

Copyright © 2020. Published by Elsevier B.V.

Language: en

Keywords

Cohort study; National Health Insurance Research Database; Occupational therapy; Physical therapy; Psychiatric disorders; Traumatic spinal cord injury